OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Provider Survey

IC 216768 under ICR 202504-2900-020 · OMB 2900-0843.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Provider Survey 2900-0843
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 10-10162 CHALENG Survey - Provider 2900-0843 Survey (Provider) 2024-11-18.docx Yes No Fillable Printable

Community and Social Services Social Services

 

3,200 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,200 0 0 0 0 3,200
Annual IC Time Burden (Hours) 320 0 0 0 0 320
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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